Adolescence represents a sensitive developmental window, marked by simultaneous neurobiological, hormonal, and psychosocial changes. This transitional period coincides with a sharp increase in mental disorders, particularly in female adolescents [1]. Compared to male adolescents, females are at higher risk of depression, anxiety disorders and suicide attempts – a disparity that cannot be explained by social factors alone – while males are more likely to die by suicide [1].

One major neuroendocrine transition of female puberty is the onset of menstrual cycles (menarche), which is characterized by rising and fluctuating estradiol and progesterone concentrations, and initially involves anovulatory and irregular cycles [2]. These cycle-related ovarian hormone fluctuations interact with cortico-limbic brain regions that are involved in affective and cognitive processes, contribute to pubertal brain maturation, and are linked to mental health [3].